THE BALANCE OF HEALTH

DEALING WITH OURSELVES:

WORKING OUT DYSFUNCTIONAL BEHAVIOR

THE STRESS OF BEING “SUPERWOMAN”

You know the type, perhaps from firsthand experience. She’s the woman who feels compelled to do and be everything-career woman, wife, girlfriend, mother, housekeeper, daughter, sister, comforter, friend, neighbor, cook, chauffeur and so on. There’s the tendency for this kind of person to not only try to do it all, but to do it all right (if not perfectly) all the time.

Talk about pressure! As though societal pressures to succeed were not enough, this woman applies a lot of the pressure on herself. It’s hard to balance both home and workplace. But this woman tries. And. in fact, has to do it.

Dr. Carol Kleinman, Director of Outpatient Services at Green Oaks Resource Centers, makes reference to a recent article in the New England Journal of Medicine that states women are increasingly becom-ing Type A personalities, with the negative consequences of greater susceptibility to the same kinds of stress-related medical syndromes as men arc and have always been prone to-high cholesterol levels, heart attacks, ulcers, insomnia, and stress migraine headaches.

“Plus, on the psychological level,” Klein-man adds, “you have women who feel frustrated and helpless. Men don’t have the same pressure because even though they ; may be husbands and Fathers in addition to being career oriented, they don’t feel quite so compelled to be superdad. In addition, the wife-especially a woman who’s on her way up in her own career, is usually being emotionally supportive of a husband who’s on his way up and often has to be, the hostess and so on and so forth.”

As a way of compensating, something usually has to give. Some women are opting out of that role where they have to succeed in all areas and they’re choosing once again to stay home with the kids, not to have to “make it” in their careers, or they’re delaying children and having smaller families as a way of compensating.

Is it worth it? Does something have to give in all cases? Kleinman says, “for the woman who’s able to juggle all those halls simultaneously, who finds the way to make it work, sure it’s worth it. But for the woman who’s not coping, who feels like she’s not doing it right, something is suffering. For her it’s not worth it.”

In addition to teaching women traditional stress reduction techniques (everything from relaxation exercises to fitness, to putting a fish tank in your office), Kleinman points out other specific guidelines that are important to a woman, “Cut out the non-essentials,” she stresses.

“Delegate responsibility and make sure other people do their fair share. That’s im-portant in the workplace and at home.”

“When we explore executive stress in men, we tend to focus on work. When we explore stress in the superwoman, we have to explore stress in both areas of their lives. Time management becomes an important issue.”

The other thing that’s important for this woman is that when things don’t work out, when she has to miss a PTA meeting because of a budget planning meeting at the office, she has to let that be ok. It doesn’t mean failing. A more realistic attitude towards defining what failure is needs to be developed.



EATING DISORDERS

Fear. The fear of getting fat. HCA Willow Park Hospital reports it is that fear that is the underlying reason for two of the country’s major eating disorders: anorexia nervosa and bulimia. They are self destructive obsessions with dieting, fasting and vomiting-excessive behaviors which can be physically and mentally debilitating, even fatal.

One in every 250 people in the United States has anorexia nervosa, 15 to 20 percent of all college-age women are bulimic, and the numbers are quickly rising.

Chances are that you know someone who presently endures an eating disorder. And like most people, you probably don’t know what you can do to help. Typically, eating disorders are misunderstood, misdiagnosed and generally, mistreated. In most cases, the troubled person does not realize he or she has a problem. Friends and relatives see it, but don’t know what it is or how to handle it. Following arc the identifiable characteristics of these two major eating disorders.

Anorexia nervosa. until recently, was unheard of. It is an illness characterized by self-starvation and is primarily found among adolescent girls and young women. Sufferers have a distorted body image and are intensely afraid of becoming obese. Because of their distorted body image, anorectics may be convinced that they are fat when in fact they are dangerously emaciated. They often lost 15 percent or more of their original body weight by consuming little food, exercising obsessively and purging (self-induced vomiting.)

Bulimia is a disease characterized by recurring episodes of binging on huge quanitities of food, frequently followed by purging, fasting, or the use of laxatives and diuretics. This behavior is again primarily seen in young women. The binge/purge cycle is marked by fluctuations in weight as well as extreme mood shifts. Bulimics often are extremely depressed. Feelings of despair, self-hatred and self-deprecation may precede or follow a binge episode.

There are several strong eating disorders programs offered by hospitals in the Dallas area, including Charter Hospital of Dallas and The University of Texas Southwestern Medical Center.



DEPRESSION: A COMMON DISORDER THAT CAN BE BEATEN

Today, depression is considered a major public health problem. It is a problem not only because the incidence of depression is significant- surveys suggest that as many as 15 percent of adults have some depressive symptoms at any given time-but also because most cases of depression go unrecognized and untreated.

In his book “Beating Depression,” published by Facts On File, Dr. John Rush of the University of Texas Southwestern Medical Center gives a concise history of depression and its cross-cultural prevalence, offers an in-depth look at how depression is diagnosed, describes the various types of depression and their causes and discusses the methods of treatment available to the depressed person.

Everyone experiences depression at some time. This volume provides sensible advice for combating the potentially debilitating effects of this common disorder.



WOMEN’S HEALTH:

NEWS AND VIEWS

THE BIRTHING ROOM BOOM

While many women continue to choose the traditional approach to childbirth- laboring in the labor room, delivering in the delivery room, and recovering in the recovery room-more couples are opting for the warm, relaxing atmosphere of a birthing room distinctly appointed and furnished to allow family members to share in the childbirth experience.

“Since the first-time mother has no prior maternity experience on which to compare, she’s usually most attracted to the comfort and decor of the room, plus the fact that her husband can spend the night,” says I.avona Wilkes, R.N., Director of’ Women and Children’s Services at Irving Healthcare System’s Women’s Pavilion of Health.

Referring to the birthing room as the LDRP (Labor/Delivery/Recovery/Post-partem) Unit, Wilkes explains the big appeal for second-and third-time mothers who have already experienced traditional delivery, is simply the single-room con-cept. “In this concept, the mother comes into one room and stays there the entire ; time,” she says. “During labor, state-of-the-art equipment, including centralized fetal monitoring, is at the nurses’ fingertips.

“Near the time of delivery, the bed converts to a birthing bed. Delivery supplies and equipment are brought to the bedside. Medical gases such as oxygen are hidden behind panels next to the bed, readily accessible if necessary. Air exchanges arc controlled to provide an environment meeting standards for a sterile operating room. Following delivery, the bed con-verts hack to normal for a comfortable recovery. It’s fantastic. A first-timer doesn’t appreciate that like a second or third-time mother docs!”

Most hospitals offer a tour of maternity facilities upon request. For instance, Presbyterian Hospital of Dallas’ Margot Perot Women’s and Children’s Building conducts tours the third Wednesday of every month beginning at 7 pm in the lobby. Also offering progressive concepts in women’s health care, the Margot Perot Building is the only free-standing facility in Dallas devoted specifically to the health and well-being of women and newborns. Because of the reputation of Presbyterian’s neonatal intensive care unit, an emergency transport service has been instituted to transfer critically ill newborns from hospitals across North and East Texas.

Humana Hospital-Medical City Dallas is increasingly becoming a hospital of choice for expectant mothers. More than 350 babies are born there each month. The hospital offers a variety of birthing options, catering to the needs of families.



SEMINARS AND SYMPOSIA THE HORMONE DILEMMA:

Making educated choices about estrogen therapy. Saturday, May 6, HI am to noon. Registration and refreshments, 9:30 am.

A free symposium for concerned women, featuring an in-depth panel discussion on health management options and advanced alternative treatments in hormonal replacement therapy. Held at Medical City Dallas on Forest Lane in the Main Dining Room, Building A Reservations are encouraged. For more information call 661-7710 Sponsored by Humana Hospital Medical City Dallas and Views of Health.



SECOND WEDNESDAYS

The Women’s Center at Methodist Medical Center sponsors a seminar every second Wednesday of the month in the conference room by the women’s center. Call 944-7160 to reserve your free seat.



Bone Health:

Addressing osteoporosis and how to get and keep strong bones.

Wednesday, May 10, 12:30 to 1:30 pm



Infertility Update:

Addressing problems of current treatments and trends for the future.

Wednesday. June 14, 12:30 to 1:30 pm



TUNE IN. . . .

Statistics show that women usually make the healthcare decisions for their families. Today’s growing options in health-education television programming provide busy women a helpful means of staying in tune to the latest health matters. Health Matters is, in fact, the name of one such program presented by Dallas’ St. Paul Medical Center, which encourages viewers to learn how to develop and maintain a healthier lifestyle. Health Matters airs on KXAS-Channel 5 on Saturdays at 5 pm and is re-broadcast on Sunday mornings at 7 am. Following are descriptions of a few upcoming Health Matters programs:

April 29-Menopause: Myths and Facts. A surprising number of women don’t really know fact from fiction when it comes to understanding the end of their cycle. Dr. Luis Leib and Dr. Jan Goss look at treatments for the more severe symptoms of menopause and explore this sometimes frustrating time in a woman’s life.

May 20-The Weekend Athlete Dr. Richard Jones. Orthopedic Surgeon, and Dr. Richard Rehm. Sports Medicine Specialist, discuss how the techniques and devices developed for professional sports arc being used by the weekend athlete.

May 27-Pregnancy after 35. Dr. Charles Van Duyne and Dr. Victor Vines, obstetrician/gynecologists, explain the risks of postponing motherhood and what can be done to reduce them.

*Check your local TV listing prior to viewing. Programs are subject to unscheduled pre-emptions.

WEIGHT CONTROL:

A LESSON IN MANAGING THE WAY WE LIVE

WINNING AT LOSING:

MEDICALLY SUPERVISED WEIGHT LOSS

Weight loss is not a cure, but weight management is. This winning word combination describes a lifestyle that an increasing number of overweight individuals arc learning to live with as they discover the Dallas area’s variety of medically supervised weight loss programs.

According to a report by the Surgeon General on Health Promotion and Disease, 1979, more than 50 percent of deaths, disease and changes in health status in this country are due to individual lifestyle health habits. This report concluded that the way Americans live their lives is more responsible for their overall health than heredity, environment and medical treatment put together. One of the most serious health problems in this country, which is linked to many diseases and is directly related to the changing American lifestyle. is obesity.



CONSIDER THESE FACTS:

FACT: Today over 25 percent of the American population is more than 20 percent over ideal body weight. FACT: Diabetes develops three times more often among obese individuals than non-obese individual FACT: Hypercholesterolemia develops 2.1 times more often in young overweight individuals.

FACT: The risk of developing hypertension in obese 20-45 year olds is 5.6 times that of age-matched non-obese individuals.

Today, it is estimated that over 23 million adult Americans are 20 percent or more over ideal body weight and in need of a treatment for weight loss, and more importantly, long term weight management.

St. Paul Medical Center’s Complement weight management program has been developed in cooperation with Health Management Resources (HMR), based in Boston, Massachusetts. According to HMR studies, Very Low Calorie Diets (VLCD- less than 800 calories) have been in existence and have been researched on an outpatient basis for many years. A 1983 Annals of Internal Medicine article summarizes the use of VLCD and recommends that such diets are the most effective means of treatment for the medically at-risk obese patient when the program meets the following criteria:

● It is medically supervised.

● It includes an intensive and effectiveeducational/behavioral program.

● It utilizes a high quality dietary supplement which provides protein with a superior amino acid profile and meets all essential nutritional needs.

Such a comprehensive treatment not only ensures safe, rapid and significant weight loss, but also teaches the patient the skills necessary to maintain a medically safe weight once it is achieved.

The Baylor Health Care System’s Weight Management Centers are experiencing great success with the BaylorFast medically supervised 4-phase program, which includes an extensive enrollment, a modified fast, transition phase, and maintenance- the lifelong phase. There’s also BaylorTrim for those needing to take off up to 35 extra pounds quickly and safely.

To counter the growing trend toward morbid obesity in adolescents, BaylorFast has introduced one of the first medically supervised weight management programs for teenagers that focuses on both psychological and physical problems.

BaylorTeen targets 15-to 18-year-olds who need to lose at least 30 pounds, and is modeled after BaylorFast’s three-year-old adult program.

The incidence of obesity in adolescents is increasing faster than in any other age group in the United States, according to W.H. Dietz, Jr., M.D., medical researcher and author.

“Ninety-five percent of morbidly obese adults began gaining as adolescents,” says Charles Walker, M.D.. BaylorFast medical director. “If we can reverse the tendency to gain weight that early, we can decrease mortality rates.”

Other successful, medically supervised weight loss programs include Presbyterian Hospital of Dallas’ Optifast, Valley Ranch Medical Center’s MediFast, Green Oaks Resource Centers’ ThinFast and Dallas Diagnostic Associations’ Balance.

If you’re confused as to which program best suits your needs, most Dallas-area hospitals have referral lines such as Charter Suburban Hospital’s Weight Management Referral Line at (214) 320-7750 or 1-800-562-6686. The referral system is designed to take the confusion out of selecting a weight management program. Weight management counselors are trained to assess your weight control needs over the phone, and to provide you with specific information on programs that meet your needs. Referral line services are usually free and with no obligation to contact programs listed.



CARE FOR CAREGIVERS:

THERE IS HELP

CAREGIVING: YOU’RE NOT ALONE

Caregiving, by itself often a full-time job, is usually added to existing responsibilities in the home or the workplace. Too many caregivers feel as though they are failures if they don’t want to or can’t care lor their loved ones by themselves. Don’t make that mistake. It is not realistic to ex-pect one person to know and do everything in a caregiving situation. You are not a failure if you seek professional, help or training on how to be a better caregiver or how to cope with your emotions. You are not a failure if you take advantage of outside services, or if you admit that your job is difficult or unpleasant, and that you need a break from it. You are not a failure if your loved one ultimately requires placement in a hospital or nursing home. Make a list of the caregiving tasks you can do. Then seek help from family and friends, or from the network of aging services, for the tasks you either can’t or don’t want to do.

The earlier you obtain support and assistance, the better able you will be to cope over a long period of time and maintain your own well being. Don’t wait for a crisis to occur. If you are a family caregiver, take the positive step of seeking assistance now.

Treemont Retirement Community’s “Treemont Vacation ” is a program designed for families who want to take a vacation and not worry about leaving elderly parents or relatives alone while they are gone In addition to serving this need, Trecmont’s Executive Director, Mary Ellen Moss, relates that a number of elderly people have taken the Treemont Vacation as an opportunity to “try us out.”

“A move to a retirement community is a major move for senior citizens and a number of them have told us that this is a very non-threatening way in which they can see what life is like in our community,” says Moss. “In most every instance the people have returned to us on a full-time basis.”

In response to the growing awareness of Alzheimer’s disease and the very specific needs of its victims. Treemont’s newest addition is the Cambridge Suites-a residential Alzheimer’s care area.

“We had noticed over the years that there was a gap in services provided for Alzheimer’s residents,” Moss slates, “especially for the people in the earlier stages who could not live independently, but did not need nursing home care. We have taken a wing of our building, secured it. and staffed it with social workers, activity directors, and home health aides, all of whom have been trained by Dr. Paul Chaf-etz of UT. Southwestern Medical School.

“While the areas has been open for only a few months, we have noticed remarkable changes with the people who are now living there. Dealing with parents with Alzheimer’s is probably one of the most stressful events in people’s lives, and we’re excited to be able to make this option available to Alzheimer’s patients.

Another welcomed option in caregiving is Doctors Nursing Center’s Adult Day Care Program. To make a comparison, it’s like a mothers’ day out program, only instead of mother dropping off the kids, it may be a son or daughter, husband or wife, dropping off a parent or spouse in order to take a much needed break in caregiving responsibilities.

The cost is $30 per day, and the hours are daily, 8 am to 6 pm. According to Nancy Ownby, Admission Director, caregivers of Alzheimer’s patients have been particularly receptive 10 the program, which offers stimulating planned activities to meet individual needs, morning and afternoon snacks, two balanced meals, and assistance with activities of daily living.

HAIR LOSS; WHAT ARE THE CHANCES OF GETTING IT BACK

There arc many factors that contribute to excessive hair loss. Serious illness, reaction to medication, stress, and damage in the hair and scalp are responsible for about 5 percent of hair loss in men. Male pattern baldness is responsible for 95 percent of all hair loss in males and is primarily influenced by geneties. hormones, and age. Similar percentages apply to women and female pattern baldness, and although women with thinning hair don’t become as bald as men eventually do. most any balding woman or man would like to know what the chances are for regrowth of hair.

According to David A Whiting. M.D. , Medical Director. Baylor Hair Research and Treatment Center, the chances depend on the cause of hair growth.

“Hair cannot be expected to grow in areas of the scalp which have been damaged severely enough to cause destruction of hair follicles with permanent scarring.’ states Whiting. “On the other hand, there are many non-scarring causes of alopecia (hair loss), in which the possibility for future re-growth must exist The problem is to find out which patients are capable of responding to appropriate treatment”

In the practice of Dallas dermatologist David Alkek, M.D., statistics show that medical treatment using Rogainc (developed by Upjohn Co. and the first medication effective for the treatment of male pattern baldness of the crown of the head) has shown 50 percent effectiveness in growing some hair. Alkek says 15 percent of that was good hair, 35 percent grew “a little fuzz.”

“In addition.” says Alkek. “Rogaine has prolonged the growth rate of patients’ existing small hairs, and most all patients notice the treatment appears to arrest hair loss and recession, so that they’re keeping the hair that they have.” Alkek states that whereas 90 percent of men will notice the preventative benefits of Rogaine. only 50 percent will grow new hair.

Research also shows that Rogaine is more effective in younger men and also in women. Rogaine hasn’t been approved for women by the Food and Drug Administration, but some women are persuading doctors to prescribe it for them anyway. With as many as 20 million women suffering from thinning hair. Upjohn plans to submit supporting data for review by the FDA in July.